Baltimore VA Slowest to Process Disability Claims

Baltimore Sun|Jan 28, 2013|by Yvonne Wenger

The Baltimore office of the U.S. Department of Veterans Affairs is the slowest in the country in processing disability claims for servicemen and servicewomen -- averaging about a year -- and makes more mistakes than any other office.

The failures locally are a symptom of a national breakdown: Across the country, more than 900,000 veterans wait an average of nine months for the agency to determine whether they qualify for disability benefits, according to the VA.

Even as the VA says it is working to fix problems in Baltimore and nationwide, Paul Rieckhoff, founder of Iraq and Afghanistan Veterans of America, calls the situation "shameful."

"You have to think about that young veteran in Baltimore who has just come back from his third or fourth tour," he said. "They are stuck in limbo, and our veterans deserve better than that."

Officials with the VA acknowledge as much. A spokeswoman for the agency called the delays "unacceptable" and said the VA is focused on clearing its backlog and getting veterans the benefits that they have earned and deserve.

Yet meanwhile, the delays continue.

Robert Fearing, a combat veteran of the Iraq war and a Bronze Star recipient, has been hospitalized three times for paranoia and anxiety caused by post-traumatic stress disorder since he filed his disability claim with the Baltimore office 21/2 years ago. He's still waiting for his benefits.

"I have gone through war fighting the enemy and now I need to fight my own government for the benefits I deserve," said Fearing, who was an Aberdeen resident when he filed his claim but now lives in Stafford, Va. "It is absolutely frustrating and despicable."

Fearing said the base where he was stationed, about 50 miles north of Baghdad, was attacked by mortar rounds more than 150 times in the six months he served there from 2004 to 2005.

The trauma left him with paranoia, a belief that he's being investigated and followed, a feeling "you can't shake out of your head," said Fearing, 44, who is married and has two daughters at home. Fearing, who retired from the Air Force in 2007 after serving for 20 years, earned a master's degree while he was in the military to further his career in counterintelligence. But he said the work now triggers debilitating anxiety and he is seeking an early retirement from his government job.

"The real issue with it is, I want someone to acknowledge the fact that I've got it. I've had to acknowledge it and I have to live with it. What more do they need? Me to be hospitalized again?" he said.

The backlog, lag time and error rates at the VA have been the focus of congressional hearings, a cause for outrage by military advocacy groups and the subject of repeated media investigations. Yet the situation has grown significantly worse.

The VA has acknowledged that the problems at the Baltimore office, which serves all of Maryland, are severe enough to warrant additional training and quality checks.

Nationally, the VA processed more than twice as many claims in 2012 as it did in 2001, but it has been unable to keep up with demand. A recent report by the Government Accountability Office shows that the agency completed 6 percent more claims from 2009 to 2011, but the caseload grew by 29 percent in the same period.

For three consecutive years, the VA has processed more than a million disability claims, which is more than double the number processed in 2001.

And claims are expected to continue to increase as the country transitions from a decade at war.

Disability compensation, which can range from about $125 to $3,000 in monthly payments, is available to veterans who sustain an injury or worsen an existing condition while on duty. The VA is experiencing a historic level of claims from Iraq and Afghanistan veterans, whose disabilities tend to be more complex than cases in the past. Outside of petitioning the help of veterans advocates, elected officials and lawyers to pressure the VA, veterans have virtually no recourse available while they wait.

Rieckhoff said it is shocking that the problem has grown worse over more than a decade at war.

"This is an unacceptable situation," Rieckhoff said. "Veterans are angry and they should be. ... Baltimore is one of the worst areas, but this is national problem that the president has failed to conquer."

The average number of days that veterans across the U.S. wait for an initial decision jumped from 166 days to 262 days, or nearly nine months, over the past two years. The VA's stated goal by 2015 is to process all claims within 125 days, but as it stands now about 70 percent of claims are older than that.

Veterans who contest the agency's decision can wait years on top of the time it takes to initially process a claim. If claims are eventually awarded, the benefits are retroactive.

In Baltimore, the average wait time for an initial decision is almost 12 months.

About 84 percent, or 16,800 of the 20,000 local claims, are older than 125 days, giving Baltimore the highest percentage of backlogged cases in the country as of Jan. 19.

Five other cities -- Boston, Chicago, Los Angeles, Oakland, Calif., and Reno, Nev. -- have caseloads with backlogs of 80 percent and higher. The percentages fluctuate slightly week to week.

The error rate in Baltimore is also the highest in the country at 26.2 percent. The average error rate nationally is 13.7 percent.

The VA said it has undertaken several initiatives to improve performance in Maryland, home to more than 450,000 veterans. The office has a history of troubles. In 2009, an audit by the VA's inspector general found that the office "did not meet the requirements for 14 of the 15 operational areas reviewed and senior management acknowledged its workload was not under adequate control."

The audit called on Baltimore's management team to provide additional oversight and training for employees who process claims for certain conditions, including diabetes and traumatic brain injury.

The auditors also recommended that a remedial action team be assigned to Baltimore to train and support operations. As a result, twice a month the agency's Eastern Area director was assigned to conduct performance briefings on the Baltimore office, among other actions.

What's more, a 2011 audit of systemic issues at VA regional offices showed that Baltimore was tied for the worst-performing of the 16 cities inspected. Baltimore's compliance rate, based on a sampling of inspections on operational activities, was 7 percent, tied with Anchorage, Alaska. The auditors attributed part of the problem to the fact that Baltimore's office had a key management position vacant for six months.

As a response to the problems, the VA said it established a quality review team in Baltimore last year to perform quality checks and regular end-of-month reviews to improve training, reduce errors and decrease the time spent reworking claims.

A new national model intended to take a case-management approach to claims processing was put in place in Baltimore last month.

The local office is also set to move to a Web-based claims-processing system later this year. The database, called the Veterans Benefits Management System, was piloted at about a third of the VA's 56 regional offices last year. It will eliminate paper files, which sometimes contain thousands of documents that can be lost or misplaced as a case is handed off multiple times.

"We recognize that too many veterans are waiting too long to get the benefits they have earned and deserve. That's unacceptable, and that's why VA is building a strong foundation for a paperless, digital disability claims system -- a lasting solution that will transform how we operate and eliminate the claims backlog," Meagan Lutz, a VA spokeswoman, said in a statement.

The agency attributes the ballooning claims backlog to several factors. Approximately 45 percent of Iraq and Afghanistan veterans are seeking compensation, which is a historically high percentage for wartime service. That's compounded by the severe and complex nature of their injuries. The new veterans claim an average range of eight to 10 disabilities, such as hearing loss and PTSD. That's more than double the number of conditions from Vietnam-era claims.

The backlog also grew, according to the agency, when the VA expanded access to benefits for medical conditions related to Agent Orange, Gulf War illness and combat PTSD.

Joseph Moore, a partner at Bergmann and Moore, a Bethesda-based law firm that helps veterans appeal disability claim decisions, said the delay in processing claims carries grave consequences for injured servicemen and servicewomen.

"VA's chronic delays and frequent mistakes processing claims inflicts serious harm on our wounded veterans who need VA benefits to feed and house their families," Moore said in a statement.

Veteran Michael Friend III of Walkersville in Frederick County has been waiting for more than three years after he appealed the decision on a claim filed in the Baltimore office.

Friend said his home fell into foreclosure while he fought the VA for disability benefits after he was medically discharged from the Army and the Social Security Administration declared him permanently disabled. Friend said he has chronic headaches, back problems and fibromyalgia.

"I am very disappointed; I am depressed," Friend, 41, said. "I feel like the government is doing me wrong.

"I am about to lose my house. It's been a lot. It's been real hard for my family and myself. I wouldn't wish this on anybody. Imagine the depression you would go through, and losing everything you have while you're waiting for someone else to decide your fate."

Friend served in the Army from 1990 to 1999, and filed his disability claim in 2009. He said his health problems were exacerbated when he was in a car accident on his way home from work at Fort Ritchie, a base that has since closed.

Disabled veterans qualify for benefits from both the VA and the Social Security Administration. While the VA benefits have to be tied to military service, Social Security benefits depend on medical documentation that proves a disability, said Brett Buchanan, a claims agent with Allsup, a company that helps individuals file disability claims.

Although the Social Security Administration is facing its own backlog, the agency created its Wounded Warrior program in 2005 to speed up processing time for disability claims submitted by veterans. Applications submitted by servicemen and servicewomen injured on duty since 2001 are flagged by the agency and expedited.

Receiving Social Security disability benefits can take years for many people. That agency denies more cases than it approves after initial reviews, but specific data on how veterans fare aren't available.

The SSA has processed more than 55,000 disability applications for servicemen and servicewomen since it began tracking the data in 2009.

But experts say a large number of veterans don't even apply for disability.

"Some veterans hole up; they isolate," Buchanan said. "They may not seek medical treatment for the first couple of years. These programs are decided on medical evidence."

Darin Selnick, an Air Force veteran, independent consultant and member of the Concerned Veterans for America's organizing committee, said the situation for disabled veterans will improve only when the public applies enough pressure on the VA, Congress and White House.

Selnick, who held several jobs at the VA, including special assistant to the secretary, said the agency has the ability to fix its accuracy troubles and eliminate the backlog. He suggested that the agency's management needs an overhaul and employees need to be better trained.

"They are poorly led, poorly managed, and the results speak for themselves," Selnick said. "You've got to demand results. You've got to track that progress. What gets measured gets done. And it's not like nobody knows what to do."

Fearing, the Iraq veteran, said that at age 44 he feels like he has to start over, because he has spent the past two decades working in a career he can no longer perform.

If he had the chance, he'd love to talk to the president and VA leaders.

"I would tell them, with all due respect, 'The system is broken. The system is hopelessly broken,'" Fearing said. "It's a crying shame."